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CPR1 Exam 1 > 19- Great Vessel Development > Flashcards

19- Great Vessel Development Flashcards

1
Q

These are outgrowths of head and neck mesenchyme. Each contain a cranial nerve and artery.

A

Pharyngeal Arches

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2
Q

Arteries known as _______ _______ arise from the _______ _______, which is an expansion at the distal most portion of the Truncus Arteriosus.

A 
Aortic Arches (AA)
Aortic Sac
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3
Q

Aortic Arches (AA) connect the Aortic Sac with the _______ _______. There are 6 pairs of Aortic Arches, and the _______ pair never really forms.

A

Dorsal Aorta

5th

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4
Q

Aortic Arches are formed within the Pharyngeal Arches by…

A

Vasculogenesis and Angiogenesis

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5
Q

Alterations of the primitive system occur, and the adult pattern is achieved by 3 types of changes. These are…

A

1) Hypertrophy of some vessels (AAs 3, 4, 6)
2) Addition of new vessels (i.e., External Carotid and distal part of Pulmonary A.)
3) Loss of some vessel segments

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6
Q

Paired Dorsal Aorta fuse beginning at the ______ axial level and continues caudally.

A

T4

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7
Q

Division of the Truncus Arteriosus by the Aorticopulmonary Septum divides it into…

A

Aorta

Pulmonary A.

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8
Q

__________ Arteries form via vasculogenesis (within the Paraxial Mesoderm) and connect with the Dorsal Aorta. These vessels run between Somites.

A

Intersegmental

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9
Q

T/F. Intersegmental As. then go on to interconnect to one another cranially and caudally.

A

True

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10
Q

How many Cervical Intersegmental As. are there?

A

7

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11
Q

Describe the fate of the Cervical Intersegmental As.

A

They are united by longitudinal anastomosis and then the roots of 1-6 drop out, but the 7th remains. Vessels derived from the longitudinal anastomosis become the Vertebral As. and the 7th Intersegmental A. remains on the left and forms the Subclavian A. The 7th Intersegmental A. on the right forms a portion of the right Subclavian A. (along with AA IV).

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12
Q

How many Thoracic Intersegmental As. are there?

A

12

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13
Q

Describe the fate of the Thoracic Intersegmental As.

A

Superior/Inferior Thoracic anastomoses between the Intersegmental As. contribute to the formation of the Internal Thoracic As. The Intersegmental As. themselves becomes the Anterior and Posterior Intercostal As.

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14
Q

How many Lumbar Intersegmental As. are there?

A

5

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15
Q

Describe the fate of the Lumbar Intersegmental As.

A

Lumbar anastomosis involved in making the Epigastric and Iliac vessels.

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16
Q

Describe the fate of AA 1.

A

Works for awhile but disappears. A small part of it may contribute to Maxillary A.

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17
Q

Describe the fate of AA 2.

A

Works for awhile but disappears. A part of it becomes the Stapedial As.

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18
Q

Describe the fate of AA 3.

A

This is the Carotid Arch. It is the main feeder to the head and will form the Common Carotid As. and proximal portion of the Internal Carotid As (remainder comes from Dorsal Aorta). A sprout of AA 3 will form the External Carotid As. as well.

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19
Q

This Aortic Arch becomes very big (hypertrophies) and each side has different outcomes.

A

AA 4

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20
Q

Describe the fate of AA 4 on the left side.

A

Forms 2nd part of the Aortic Arch in the newborn.

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21
Q

The _______ _______ of the outflow tract (this is what divides the Truncus Arteriosus) ensures the connection of the left AA 4 to the Left Ventricle.

A

Spiral Septum

***Remember, AA 4 becomes the 2nd part of the Aortic Arch!

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22
Q

What are the 4 parts of the Aortic Arch derived from?

A

1st Part = Aortic Sac

2nd Part = Left AA 4

3rd Part = Left Dorsal Aorta (Proximal to 7th Intersegmental A.)

4th Part = Left Dorsal Aorta (Distal to 7th Intersegmental A.)

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23
Q

Describe the fate of AA 4 on the right side.

A

Forms proximal part of right Subclavian A.

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24
Q

What are the parts of the right Subclavian A. made of?

A

Proximal part = Right AA 4
Middle part = Right Dorsal Aorta
Distal part = Right 7th Intersegmental A.

***Remember, on the left the 7th Intersegmental A. makes the entire Subclavian A.!

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25
Q

Describe the fate of AA 5.

A

It never forms.

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26
Q

Describe the fate of AA 6 (for both sides).

A

Become Pulmonary As.

***However, each side progresses a little differently!

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27
Q

For AA 6, each side forms a new outgrowth that enters the mesenchyme of the lung (intrapulmonary portion). Each Pulmonary a. is formed from the proximal portion of AA 6 and the _______ _______.

A

Aortic Sac

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28
Q

The heart starts developing in the _______ region, but as the embryo grows, the heart ends up in the Thorax.

A

Cervical

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29
Q

Carotids lengthen while the proximal ends of the _________ Arteries end up lower in the fetus.

A

Subclavian

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30
Q

Describe the fate of AA 6 on the right side.

A

There is a regression of the distal part of the right AA 6, causing it to lose connection with the right Dorsal Aorta. This causes the Right Recurrent Laryngeal N. (nerve supply to 6th PA structures, ie Larynx) to become hooked around the future right Subclavian A.

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31
Q

Describe the fate of AA 6 on the left side.

A

The connection (Ductus Arteriosus) is retained so that the Left Recurrent Laryngeal N. remains hooked around the distal AA 6. The Ductus Arteriosus will eventually become the Ligamentum Arteriosum.

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32
Q

The Dorsal Aorta portions between the AA 3 and AA 6 is called the _______ _______. This portion is obliterated.

A

Carotid Duct

33
Q

The right Dorsal Aorta disappears between the right 7th Intersegmental A. and its junction with the left Dorsal Aorta. The remaining caudal segments of the right and left Dorsal Aorta fuse to form the…

A

Descending Thoracic and Abdominal Aorta

34
Q

These are vessels supplying the yolk sac that will eventually form the GI vasculature.

A

Vitelline Arteries

35
Q

These are paired ventral branches of the Dorsal Aorta that course to the placenta and have connections with the developing bladder.

A

Umbilical Arteries

36
Q

A new connection is made between the ______ ______ Intersegmental Arteries and the distal Umbilical Arteries, and then the original proximal connections to the Dorsal Aorta regress in the embryo.

A

5th Lumbar

37
Q

After birth, the distal end of the Umbilical Arteries is obliterated (part heading to the Umbilical Cord at the Umbilicus) and become the ________ _______ _______. The more proximal portion off the 5th Lumbar Intersegmental Arteries (Iliac vessels) are still referred to as ________ _______ in the adult with the ________ ________ ________ branching off them and supplying the bladder.

A

Medial Umbilical Ligaments
Umbilical Arteries
Superior Vesicular Arteries

38
Q

In fetal circulation, oxygen-rich blood bypasses much of the liver via _______ _______ and enters the Inferior Vena Cava and Right Atrium. The bulk of the Inferior Vena Cava blood passes through the _______ _______ into the Left Atrium, while a smaller portion enters the Right Ventricle.

A

Ductus Venosum

Foramen Ovale

39
Q

In fetal circulation, most of the Superior Vena Cava blood is directed into the _______ _______.

A

Right Ventricle

40
Q

About 90% of the blood in the Right Ventricle enters the descending aorta via ________ ________ (connects Pulmonary Trunk to Descending Aorta to bypass the lungs). Only about 10% blood will flow into the lungs.

A

Ductus Arteriosus

***Remember, after birth this becomes the Ligamentum Arteriosum!

41
Q

Arteries of the heart, head, neck, and UE receive blood from the Ascending Aorta and contain the highest level of ________ content.

A

Oxygen

42
Q

This is a medical condition in which the Ductus Arteriosus fails to close after birth. Occurs in 8/10,000 births.

A

Patent Ductus Arteriosus

43
Q

In the fetus, _________ (a vasodilator) keep the Ductus Arteriosus open prior to birth. After birth, changes in blood oxygen tension together with a sudden drop in _________ (mostly maternally driven) levels and an increase in _________ release from the newborn lungs stimulates smooth muscle contraction of the Ductus Arteriosus, causing it to close within 10-15 hours after birth.

A

Prostaglandins
Prostaglandin
Endothelin (A growth factor released by endothelial cells)

44
Q

After birth, if the Ductus Arteriosus remains open, 1/3 to 1/2 of the blood traveling via the Aorta will enter the Pulmonary A. because the systemic blood pressure is (HIGHER/LOWER) while the pulmonary blood pressure is (HIGHER/LOWER).

A

Higher

Lower

45
Q

If the Ductus Arteriosus fails to close after birth, because of the re-entry of blood into the lungs, blood is circulated through the lungs _______ times for every one time it enters the systemic circulation. This means an extra workload for the Left Ventricle, leading to Left Ventricle _________.

A

2-3

Hypertrophy

46
Q

If the Ductus Arteriosus fails to close after birth, because of increased blood flow to the lungs, it increases Pulmonary ________ which eventually leads to pulmonary congestion and then eventually ________ _______ ________. After 1-3 years, one can hear a blowing-type of murmur.

A

Resistance

Congestive Heart Failure (CHF)

47
Q

There is an increased risk for Patent Ductus Arteriosus with ________ ________ infection during early pregnancy.

A

Maternal Rubella

48
Q

Treatment to help close the Ductus Arteriosus includes giving _________ inhibitors or surgery if need be.

A

Prostaglandin

49
Q

This occurs in 3/10,000 births and occurs when the Aortic lumen below (distal) to the origin of the left Subclavian A. is narrowed due to abnormal thickening of the Aortic wall. The constriction may be before or after the Ductus Arteriosus. More frequent in Turner’s Syndrome.

A

Coarctation of the Aorta

50
Q

________ Coarctation of the Aorta (in adults) is sometimes not noticed because collateral circulation is established through Intercostal (Intersegmental) As. and Internal Thoracic As., etc.

A

Postductal

***This means the coarctation occurs after the Ductus Arteriosus!

51
Q

In ________ Coarctation of the Aorta, collaterals are usually not well developed. After birth, little or no blood gets to the lower body and legs unless Ductus Arteriosus remains open (O2 poor blood from Right Ventricle). Many times, child dies without surgery if coarctation is severe.

A

Preductal

***This means the coarctation occurs before the Ductus Arteriosus!

52
Q

This type of abnormal vessel development is due to the right Subclavian being formed by the distal portion of the right Dorsal Aorta and 7th Intersegmental A. The right AA 4 and proximal part of the Dorsal Aorta are obliterated.

A

Aberrant (Abnormal) Origin of Right Subclavian

***Remember, the right Subclavian normally consists of the proximal portion of right Dorsal Aorta, 7th Intersegmental A., and AA 4. The distal portion of the right Dorsal Aorta is what is supposed to obliterate!

53
Q

Aberrant (Abnormal) origin of the right Subclavian A. may cause difficulties in swallowing (dysphagia) and respiration (dyspnea). Why is this?

A

Because the right Dorsal Aorta must cross the Esophagus to reach the right upper limb.

***Incidence is about 1% of the population, which many being asymptomatic.

54
Q

This abnormality is composed of a vascular ring surrounding the Trachea and Esophagus. It may lead to Esophageal dysfunction and strangulation of the Trachea.

A

Double Aortic Arch

55
Q

This abnormality occurs when the left AA 4 and left Dorsal Aorta completely obliterates and are replaced by corresponding vessels on the right. This may cause complains of dysphagia and dyspnea if the left Subclavian A. passes behind the Esophagus and the Ligamentum Arteriosum passes in front of the Trachea to reach the right side.

A

Right Aortic Arch

56
Q

This abnormality is similar to an abnormal right Subclavian A. except the left AA 4 disappears as well. Ductus Arteriosus remains open and descending Aorta and Subclavian As. are supplied with blood of low oxygen content. The Aortic Trunk supplies the two Common Carotid As. Often seen in DiGeorge Syndrome and is life-treating unless one intervenes.

A

Interrupted Aortic Arch

57
Q

Venous development consists of 3 main systems, which are…

A

Vitellins System
Umbilical System
Cardinal System

58
Q

This venous development system carries blood from the yolk sac to Sinus Venosus.

A

Vitelline System

59
Q

This venous development system originates in Chorionic Villi of the Placenta and carries oxygen-rich blood.

A

Umbilical System

60
Q

This venous development system drains the body of the embryo.

A

Cardinal System

61
Q

These veins initially empty into Sinus Horn as they pass through Septum Transversum, they become surrounded by Liver primordia.

A

Vitelline Veins

62
Q

As the liver develops, the Vitelline Vs. form a vascular plexus called ________ ________, within the liver primordia.

A

Hepatic Sinusoids

63
Q

As the left Sinus Venosus is reduced in size, the blood flow of the left Vitelline V. and left Umbilical V. is channeled toward the right side within the Liver. The proximal portion of the right Vitelline V. forms the right _________ _________ that eventually form the terminal part of the Inferior Vena Cava. The proximal part of the left Vitelline V. disappears.

A

Hepatocardiac Channel

64
Q

Inferior parts of Vitelline Vs. regress except for that contributing to the _______ V., ________ and ________ ________ V., and _________ V.

A

Portal V.
Superior and Inferior Mesenteric V.
Splenic V.

65
Q

These vessels pass on either side of the Liver, but become connected to Hepatic Sinusoids.

A

Umbilical V.

66
Q

Proximal part of both sides and remainder of distal right Umbilical V. disappears so the left Umbilical V. is the only one carrying ________ blood to the Liver.

A

Placental

67
Q

With increased placental circulation, a direct communication is formed between left Umbilical V. and the right Hepatocardiac Channel called the _______ _______.

A

Ductus Venosus

68
Q

The Ductus Venosus allows most of the blood to bypass the Sinusoidal Plexus of the Liver. __________ have a role in maintaining latency of the Ductus Venosus during fetal life.

A

Prostaglandins

69
Q

After birth, the left Umbilical V. and Ductus Venosus disappear forming the…

A

Ligamentum Teres Hepatis

Ligamentum Venosus

70
Q

The Anterior and Posterior _________ V. are the early drainage system of the body. Both join to form the _______ _______ V. before entering the Sinus Horn.

A

Cardinal

Common Cardinal

71
Q

Anastomoses between left and right Anterior Cardinal Vs. drain most of the blood from the _______ and _______ into the Cardinal Vs. on the right side.

A

Head

Neck

72
Q

An anastomosis between right and left Anterior Cardinal Vs. forms the left __________ V.

A

Brachiocephalic

73
Q

This is formed from the right Common Cardinal V.

A

Superior Vena Cava

74
Q

The connection of the left Anterior Cardinal V. with the left Common Cardinal V. is lost as the left Brachiocephalic V. develops. Much of the left Cardinal V. regresses along with the left Sinus Horn with remnants forming the _______ _______.

A

Coronary Sinus

75
Q

Abnormal Anterior Cardinal V. development can lead to the Superior Vena Cava draining into the heart via what?

A

Coronary Sinus

76
Q

Posterior Cardinal Vs. connect to parallel sets of veins called the ________ and ________ Vs. As these new set of veins develop, much of the original Posterior Cardinal Vs. regress.

A

Subcardinal

Supracardinal

77
Q

________ Vs. will form veins primarily associated with the kidney and gonads and contributes to formation of abdominal Inferior Vena Cava.

A

Subcardinal

78
Q

_________ Vs. will form portions of Inferior Vena Cava and Azygos system, as well as veins draining the body wall.

A

Supracardinal

CPR1 Exam 1 (22 decks)

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